Most people who are grieving will get the support they need from their existing social networks. However it is important to identify those who need more specialist support. When to refer (bereaved) provides more information.
A death can have a significant impact on the health of surviving family members, resulting in small increases in mortality, and increased symptomatology more generally. Although the use of medications and medical services often increases in the bereavement period, the most at risk patients may not seek medical assistance.
Issues to be aware of in follow up
Increased mortality in the first months of bereavement appears to be mostly due to accidental and violent death including suicide, alcohol related deaths, and increased rates of death from ischaemic heart disease and lung cancer.
Health complications most frequently associated with bereavement include:
- Clinicially significant depression may occur in 10 – 20% of bereaved people
- Sleep problems and fatigue can persist beyond the caring period and well into bereavement
- Changed social arrangements may affect patients’ physical activity levels, nutritional status, and general wellbeing, including their self-management of chronic health problems
- Alcohol use is a factor in the increased mortality associated with bereavement
- Higher intensity of grief may be associated with worsening of pre-existing problems
- Bereavement has been associated with worsening memory.
Social isolation and changes in work and other important relationships can be very significant during bereavement.
Following up the bereaved – some possible strategies
- The offer of an appointment to discuss the patient’s illness and its outcome with the GP may be appreciated
- Flagging bereaved patients for the practice nurse to contact by a phone call and an offer of a check up may be appropriate
- When a bereaved person attends the clinic, reviewing their overall health status and any active medical conditions is a priority.
Most bereaved people do not require counseling or specialist support. Simple reassurance, acknowledgment of their loss and access to information may be all that is required.
A number of risk factors for ongoing distress and impairment after bereavement are being identified. Patients who request help for themselves or a family member, or who show any warning signs, can be referred for specialist bereavement support.
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This page was created on 26 May 2009 and is due for review in May 2011.*